Associate Claims Representative

UnitedHealth Group•Tampa, FL

2d•$16 - $29•Remote

About The Position

This position is National Remote. You’ll enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges. At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. As an Associate Claims Representative you will be responsible to update claim information based on research and communication from member or provider. You will need to complete necessary adjustments to claims and ensure the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates). Communicate extensively with members and providers regarding adjustments to resolve claims errors/issues, using clear, simple language to ensure understanding and learn and leverage new systems and training resources to help apply claims processes/procedures. This position is full-time (40 hours / week), Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 6:00 AM - 6:00 PM candidate’s local time zone after core metrics are met. It may be necessary, given the business need, to work occasional overtime or weekends. We offer 12 weeks of paid training. The hours of the training will be 7:00 AM - 3:30 PM CST from Monday - Friday. 100%25 attendance is required and No PTO during training. Training will be conducted virtually from your home. This is a challenging role that takes an ability to thoroughly review, analyze and research complex health care claims in order to identify discrepancies, verify pricing, confirm prior authorizations and process them for payment. You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the member's claim. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Requirements

High School Diploma / GED OR equivalent work experience
Must be 18 years of age OR older
1+ years of experience in a related environment (i.e., office, administrative, clerical, customer service, etc.), using phones and computers as the primary job tools
Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
Experience using Microsoft Word (ability to create, edit, save and send documents) and Microsoft Excel (ability to create, edit, save and send spreadsheets)
Must be able to train for the entire 12 weeks, Mon- Fri during the hours of 7:00 AM -3:30 PM Central Time
Ability to work any of our full-time (40 hours / week), 8-hour shift schedules during our normal business hours of 6:00 AM - 6:00 PM candidate’s local time zone from Monday – Friday after core metrics are met. It may be necessary, given the business need, to work occasional overtime or weekends
Ability to keep all company sensitive documents secure (if applicable)
Required to have a dedicated work area established that is separated from other living areas and provides information privacy
Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Ability to compose grammatically correct correspondence that translates medical and insurance expressions into simple terms that members can easily understand
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Nice To Haves

Basic understanding of healthcare claims including ICD-9 and CPT codes

Responsibilities

Provide general claims support by reviewing and processing claims
Calculate other insurance and benefits
Participate in meetings to share, discuss, and solution for question or error trends, as well as potential process improvements
Consistently meet established productivity, schedule adherence, and quality standards